Episode # 70 • 30 Jun 2026
Diagnosis & Initial Management of Neuroendocrine Tumors
How do you unravel the complexity of diagnosing and managing neuroendocrine tumors, where every case demands a tailored approach? In this episode of BackTable TumorBoard, host Dr. Lingling Du is joined by Dr. Chih-Yi Liao and Dr. Xavier Keutgen to break down the essential steps from first symptoms to staging, imaging, and early treatment decisions for NET patients. The discussion covers the spectrum of NET biology, individualized imaging strategies, and when surgery or systemic therapy is the best path forward.
Timestamps
00:00 - Introduction
07:16 - Imaging Approaches for Staging Neuroendocrine Tumors
16:47 - Biomarkers for Neuroendocrine Tumor Diagnosis
22:33 - Surgical Candidacy Guidelines
26:03 - Ki-67 and Tumor Biology Consideration
30:11 - Co-morbid Obesity and GLP-1 Use
35:11 - Working Therapies to Manage Neuroendocrine Tumors
38:02 - Tumor Board Case Walkthrough and Closing Statements
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More about this episode
The doctors review the strengths and limitations of DOTATATE PET, MRI, CT, and FDG PET for diagnosis and staging, and clarify the limited role of biomarkers such as chromogranin A and serotonin. They outline key factors in surgical candidacy, including tumor location, burden, grade, and comorbidities like obesity, and discuss the use of GLP-1 and pancreas-sparing surgery in high-risk cases. The episode also examines managing discordant imaging, evolving guidelines for adjuvant therapy, and a case study where CAPTEM is used for tumor shrinkage in locally advanced pancreatic NET. Throughout, they emphasize the importance of multidisciplinary decision-making and the need for experienced pathology review in this heterogeneous disease.
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